Gotu kola

Gotu kola (Centella asiatica) has been used to treat many conditions for thousands of years in India, China, and Indonesia. It was used to heal wounds, improve mental clarity, and treat skin conditions such as leprosy and psoriasis.

Some people use it to treat respiratory infections such as colds, and in the past it was used for that in China. It has been called "the fountain of life" because legend has it that an ancient Chinese herbalist lived for more than 200 years as a result of taking gotu kola.

Historically, gotu kola has also been used to treat syphilis, hepatitis, stomach ulcers, mental fatigue, epilepsy, diarrhea, fever, and asthma. Today, in the U.S. and Europe gotu kola is most often used to treat varicose veins and chronic venous insufficiency, a condition where blood pools in the legs. It's also used in ointments to treat psoriasis and help heal minor wounds.

Gotu kola is not the same as kola nut (Cola nitida). Unlike kola nut, gotu kola does not have caffeine, and is not a stimulant.

Gotu kola is a perennial plant native to India, Japan, China, Indonesia, South Africa, Sri Lanka, and the South Pacific. A member of the parsley family, it has no taste or smell. It thrives in and around water. It has small fan-shaped green leaves with white or light purple-to-pink flowers, and small oval fruit. The leaves and stems of the gotu kola plant are used as medicine.

Treatment

Venous insufficiency and varicose veins

When blood vessels lose their elasticity, blood pools in the legs and fluid leaks out of the blood vessels. That causes the legs to swell (venous insufficiency). Several small studies suggest gotu kola may help reduce swelling and improve blood flow. In a study of 94 people with venous insufficiency, those who took gotu kola saw their symptoms improve compared to those who took placebo. In another study of people with varicose veins, ultrasound tests showed that people who took gotu kola has less leakage of fluid.

One study also found that people who took gotu kola before flying had less ankle and leg swelling than those who didn't take it.

Wound healing and skin lesions

Gotu kola has chemicals called triterpenoids. In animal and lab studies, these compounds seem to help heal wounds. For example, some studies suggest that triterpenoids strengthen the skin, boost antioxidants in wounds, and increase blood supply to the area. Based on these findings, gotu kola has been applied to the skin, or used topically, for minor burns, psoriasis, preventing scars after surgery, and preventing or reducing stretch marks.

You can find gotu kola in many creams for wound healing. Ask your health care provider if one is right for you.

Anxiety

These same chemicals -- triterpenoids -- seem to decrease anxiety and increase mental function in mice. One human study found that people who took gotu kola were less likely to be startled by a new noise than those who took placebo. Since the "startle noise" response can be a way to tell if someone is anxious, researchers think that gotu kola might help reduce anxiety symptoms. But the dose used in this study was very high, so it's impossible to say how gotu kola might be used to treat anxiety.

Scleroderma

A single study of 13 women with scleroderma found that gotu kola decreased joint pain and skin hardening, and improved finger movement.

Insomnia

Gotu kola acts as a sedative when given to animals in tests. Because of that, it is sometimes suggested to help people with insomnia. But no human studies have been done to see whether it works and whether it's safe.

Gotu kola is available in teas and as dried herbs, tinctures, capsules, tablets, and ointments. Products should be stored in a cool, dry place and used before the expiration date on the label.

Pediatric

Gotu kola is not recommended for children under 18 years old.

Adult

The standard dose of gotu kola (Centella asiatica) is different depending on what kind you use and what you use it for. Your health care provider can help you choose the right dose for you. Most studies have used standardized extracts:

Dried herb -- you can make a tea of the dried leaf, three times daily.

Powdered herb, available in capsules -- 1,000 - 4,000 mg, three times a day

Standardized extract -- 50 - 250 mg, two to three times daily. Standardized extracts should contain 40 % asiaticoside, 29 - 30 % asiatic acid, 29 - 30 % madecassic acid, and 1 - 2 % madecassoside. Doses used in studies mentioned in the Treatment section include 20 mg for scleroderma and up to 180 mg in one study for venous insufficiency, although most of the studies for this condition used 90 - 120 mg daily.

Gotu kola has been used in some studies that lasted up to one year. However, gotu kola has the potential to be harmful to the liver. It's best not to use gotu kola for more than 6 weeks without talking to your doctor. You may need to take a 2-week break before taking the herb again.

Asiaticoside, a major part of gotu kola, has also been link with tumor growth in mice. Anyone with a history of precancerous or cancerous skin lesions -- such as squamous cell, basal cell skin cancer, or melanoma -- should not use gotu kola.

People with liver disease, or who take medications that affect the liver, should not take gotu kola. Ask your doctor if you take any prescription medications, or often take over-the-counter pain relievers.

Side Effects

Side effects are rare but may include skin allergy and burning sensations with external use, headache, stomach upset, nausea, dizziness, and extreme drowsiness. These tend to happen with high doses of gotu kola.

Pediatric Use

Gotu kola is not recommended for children.

Geriatric Use

People older than 65 should take a lower dose of gotu kola. Your health care provider can help you determine the right dose for you, which can be increased slowly over time.

Drugs that affect the liver -- Gotu kola contains things that may hurt a person's liver, and taking it along with some other medications that also can harm the liver may cause liver damage.

Cholesterol-lowering drugs (including statins) -- In animal studies, gotu kola raised cholesterol levels. It may also raise cholesterol levels in humans, although no studies have been done.

Diabetes medications -- In animal studies, gotu kola seems to increase blood sugar levels. People with diabetes should not take gotu kola without first talking to their doctor.

Diuretics (water pills) -- Gotu kola seems to act like a diuretic, meaning it helps the body get of excess fluid. Taking diuretic medications and gotu kola could cause your body to lose too much fluid, upsetting the balance of electrolytes you need. The same is true of taking gotu kola with herbs that have diuretic effects, such as green tea, astragalus, or gingko.

Sedatives -- Because gotu kola acts like a sedative, it might make some drugs taken for anxiety or insomnia stronger. The same is true for herbs taken for anxiety or insomnia, such as valerian.

Wollina U, Abdel-Nasar MB, Mani R. A review of the microcirculation in skin in patients with chronic venous insufficiency: the problem and the evidence available for therapeutic options. Int J Low Extrem Wounds. 2006;5(3):169-80.